目的:通过观察分析利用“定位针”、“防旋针”治疗儿童肱骨髁上骨折的优势与疗效,探讨一种改良的经皮钢针内固定治疗方法。方法本组1100例 GartlandⅢ型儿童肱骨髁上骨折,均在 C型臂 X 线透视下行手法复位骨折端,先自肱骨远端尺骨鹰嘴外侧向肱骨髓腔方向打入“定位针”,再自肱骨外髁向内上方斜向打入“防旋针”固定骨折端。术后石膏托固定,3~4周后去除内外固定进行功能锻炼。结果本组病例均获随访,骨折均在术后3~5周愈合,平均时间为3.6周。参照 Flynn 等[1]临床功能评定标准,优921例,良107例,一般54例,差18例。优良率93.69%。结论闭合复位与经皮钢针内固定治疗儿童肱骨髁上骨折操作方便,安全性高,有利于术后骨折愈合及功能康复,值得临床推广。
Objetive Probe into the advantage and efficacy of a kind of improved percutaneous Kirschner wire inter-fixation method called“positioning pin”and“anti-rotation pin”for the Supracondylar fracture of the humerus in children,and promot and apply in clinical.Methods 1 100 cases of humeral supracondylar frac-tures in children were type of Gartland Ⅲ.These fractures were treated with manipulative closed reduction with the C arm X-ray machine.Then we used two Kirschner wires.Firstly,a 2 mm “positioning pin”was drived into the humeral medullary cavity in the distal end of the humerus,ulna olecranon outside;then,a 1.5 mm or 2 mm “anti-rotation pin”was drived from the external condyle of humerus inward to medial epicondyle of hu-merus.Postoperatively elbow was fixed with plaster external fixation,3 ~4 weeks later,removing internal and external fixation and functional exercise. Results All patients were followed up.The average healing time of these fractures was 3.6 weeks.Reference to Flynn clinical functional assessment standards:excellent in 921 cases,good in 107 cases,general in 54 cases,poor in 18 cases.The excellent and good rate was 93.69%. Conclusions Treatment with manipulative closed reduction and improved percutaneous Kirschner wire inter-fix-ation for supracondylar humeral fractures in children has the advantage of easy operation,high safety,and con-ducive to fracture healing and functional recovery after surgery.It is worthy of promotion in clinical.